Table 1.
A list of the relationship between physical activity and the mental health of people experiencing traumatic events.
| Type of accidents | Name of accidents | Authors | Nationality | Study design | Survey/subjects | Sample numbers | Psychological assessment tools | Main findings |
|---|---|---|---|---|---|---|---|---|
| Natural disasters | Tokyo earthquake | Tomata et al. (2015) | Japan | Randomised control | Middle aged and elderly people (aged 37–88) | 81 | Six-item Kessler Psychological Distress Scale (K6) | Physical activity could reduce the mental distress and disuse syndrome of disaster residents and improve the subjective quality of life. |
| Tokyo earthquake | Kuroda et al. (2018) | Japan | Prospective study | The aged (＞65 years old) | 1159 | Self-assessment Basic Checklist (BCL) | Comprehensive exercise (strength, balance and aerobic exercise, etc.) for 1 year, 2 times/month, 60 min/time could significantly reduce depression level of the elderly after the earthquake and improve their well-being. | |
| Tokyo earthquake | Tsuji et al. (2017) | Japan | Prospective study | The aged (＞65 years old) | 3567 | 15-item Geriatric Depression Scale (GDS) | Group exercise or regular walking could significantly reduce depressive symptoms of elderly survivors after an earthquake. | |
| Tokyo earthquake | Goodwin et al. (2020) | Japan | Prospective study | Adults (≥18 years old) | 2599 | K6 | There was a significant positive correlation between higher physical activity level and lower mental distress. | |
| Tokyo earthquake | Moriyama et al. (2019) | Japan | Randomised control | The aged (>65 years old) | 21 | Japanese version of the World Health Organization Five Well-Being Index (WHO-5-J) | Combined exercise intervention (walking, physical fitness lectures, etc.) lasting for 3 months and once a week could improve the subjective well-being after the earthquake. | |
| Tokyo earthquake | Utsumi et al. (2020) | Japan | Cross-sectional survey | Adults (>20 years old) | 718 | K6; Center for Epidemiologic Studies Depression Scale (CES-D); the Impact of Event Scale-Revised (IES-R) | Walking time was negatively correlated with the depressive symptoms of residents in the post-earthquake area, and walking for 30–60 min every day worked best. | |
| L’Aquila earthquake, Italy | Valenti et al. (2012) | Italy | Cross-sectional survey | Adolescents (aged 14–18) | 179 | Minnesota Multiphasic Personality Inventoried Adolescents (MMPI-A) | Exercising at least twice a week for no less than 60 min each time could reduce the anxiety level of adolescents in the post-earthquake areas. | |
| Tokyo earthquake | Nozue et al. (2017) | Japan | Cross-sectional survey | Young, middle-aged and elderly people | 6668 | K6 | Interventions targeting physical activity and dietary intake had positive effects on the physical and mental health of Tokyo earthquake survivors. | |
| Wenchuan earthquake | Tian et al. (2014) | China | Cross-sectional survey | Middle school students | 4604 | Posttraumatic stress disorder Checklist-Civilian Version (PCL-C); Structured clinical interview for DSM-IV Disorders (SCID) | High levels of physical exercise and social support were negative risk factors for PTSD. | |
| Yushu earthquake | Lu et al. (2020) | China | Cross-sectional survey | Middle school students | 4681 | the Connor-Davidson resilience scale (CDRISC) | Regular physical exercise was positively correlated with the mental resilience of adolescents after the earthquake. | |
| Extreme climate disasters such as droughts, floods and hurricanes | Brumby et al. (2011) | Australia | Cross-sectional survey | Farmers (≥50 years old) | 1813 | Depression Anxiety Stress Scales-21 (DASS-21) | Long-term droughts, floods and extreme weather events could reduce farmers’ physical activity levels, increase body weight and cortisol content, leading to abdominal obesity. In the absence of intervention, weight gain, mental health and exercise levels were increasingly compromised in a spiral. Increasing physical activity of residents in farms and agricultural communities could improve circulating cortisol levels, reduce the incidence of obesity in farm men and women, and reduce mental distress. | |
| Xiongben earthquake | Kondo et al. (2019) | Japan | Cross-sectional survey | Diabetics | 557 | IES-R | Disaster-related stress levels were positively associated with ‘increased amount of physical activity/exercise’ and negatively associated with sleep amount. | |
| Accident disasters | Fukushima nuclear accident | Kukihara et al. (2014) | Japan | Cross-sectional survey | Evacuees from nuclear accident areas | 241 | CDRISC; Zung Self-Rating Depression Scale (ZSDS); IES-R | Good exercise habit and healthy diets could improve mental resilience and reduce PTSD and depression levels of survivors. |
| Fukushima nuclear accident | Oe et al. (2018) | Japan | Longitudinal cohort | Children (aged 6–12) | 8282 | Emotional subscale in Strength and Difficulties Questionnaire (SDQ) | Physical activity was an important protective factor for mood and peer relationships of children and adolescents after a disaster. | |
| Fukushima nuclear accident | Orui et al. (2018) | Japan | Cross-sectional survey | Adults (≥20 years old) | 233 | K6 | Regular physical activity was positively correlated with the mental recovery of the disaster-stricken residents in the seven years after the nuclear accident, and negatively correlated with mental distress. | |
| Fukushima nuclear accident | Orui et al. (2017) | Japan | Cross-sectional survey | Company employees | 394 | K6 | Physical exercise and adequate sleep were important protective factors for the mental health of post-disaster residents. | |
| Fukushima nuclear accident | Itagaki et al. (2017) | Japan | Cross-sectional survey | Children and adolescents (aged 6–15) | 10824 | SDQ | Adolescents with exercise habit (i.e. daily, 2–4 times/week or once/week) had lower median SDQ scores than those without exercise habit (never participating in physical exercise). | |
| Fukushima nuclear accident | Itagaki et al. (2021) | Japan | Longitudinal cohort | Children (aged 6–12) | 7013 | SDQ | Lack of exercise habits was one of the important risk factors for peer relationship problems and severe psychological symptoms in children and adolescents in the five years after a nuclear accident. | |
| traumatic event | Whitworth et al. (2019) | U.S.A | Randomised control | Adults (aged 18–45) | 30 | Posttraumatic Stress Diagnostic Scale for DSM-5 (PDS5); State-Trait Anxiety Inventory (STAI); The Center for the Epidemiological Studies of Depression Short Form (CESD) | Resistance training of 30 min/time, 3 times/week for 3 weeks could significantly reduce the symptoms of avoidance and hyperarousal, and improve sleep quality and hazardous alcohol use. | |
| trauma and disaster events | Buchanan and Keats (2011) | Canada | ethnographic study | journalists and photojournalists | 31 | – | Exercise and other physical activities were considered as effective strategies to buffer against personal trauma, disaster events and work-related stress. | |
| Public health incidents | COVID-19 | Jacob et al. (2020) | England | Cross-sectional survey | Adults (aged 35–64) | 902 | Becks Anxiety Inventory (BAI); Becks Depression Inventory (BDI); The short Warwick-Edinburgh Mental Well-being Scale | Moderate-to-high-intensity physical activity was negatively correlated with anxiety, depression and other adverse mental conditions. |
| COVID-19 | Carriedo et al. (2020) | Spain | Cross-sectional survey | Adults (aged 16–82) | 1795 | CDRISC | Regular vigorous physical activity was associated with higher self-efficacy and mental resilience. | |
| COVID-19 | Maugeri et al. (2020) | Italy | Cross-sectional survey | Young, middle-aged and elderly people | 2524 | Psychological General Well Being Index (PGWBI) | The total energy consumption of physical activity could reduce the negative impact of the epidemic on mental health. | |
| COVID-19 | Deng et al. (2020) | China | Cross-sectional survey | Young people (aged 18–22) | 1607 | DASS-21 | Mental health was positively correlated with exercise habits or duration. | |
| COVID-19 | Zhang et al. (2020) | China | Cross-sectional survey | Children and adolescents | 9979 | Profile of Mood States Scale (POMS) | Physical activity had a significant positive impact on the emotional state of children and adolescents during the epidemic. | |
| COVID-19 | Chen et al. (2020) | China | Cross-sectional survey | Adolescent girls (aged 11–18) | 4805 | CES-D | Low level of physical activity was the main cause of emotional deterioration and an independent risk factor for depressive symptoms. | |
| COVID-19 | Zhang et al. (2020) | China | Longitudinal tracing | College students | 66 | DASS-21 | Physical activity could directly alleviate general depression, anxiety, stress and other negative emotions. | |
| Social security accidents | War | LeardMann et al. (2011) | USA | Prospective study | Male veterans | 38883 | PCL-C; Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) | Exercise activity, especially vigorous activity, was negatively associated with post-traumatic stress disorder of veterans. |
| War | Shivakumar et al. (2017) | USA | Self-control | Female veterans | 31 | Clinician-Administered PTSD Scale (CAPS) | Twelve weeks of moderate-intensity aerobic exercise could be used as an intervention for PTSD in women. | |
| war | Hall et al. (2020a) | USA | Randomised control | Veterans | 54 | CAPS, PCL-C | Comprehensive exercise intervention (including aerobic exercise, strength, flexibility and balance) of 12 weeks, 3 times/week, 60–90 min/time could improve the subjective quality of life in veterans, reduce PTSD and depression, especially negative cognition and re-experience symptoms in PTSD. | |
| War | Goldstein et al. (2018) | USA | Randomised control | Veterans | 47 | CAPS | Comprehensive physical exercise (aerobic exercise and strength training) conducted collectively for 12 weeks, 3 times/week, 60 min/time could reduce PTSD symptoms. | |
| ‘9.11’ terrorist attack | Smith et al. (2019) | USA | Structured interview | Emergency workers and paramedics involved in the rescue | 54 | – | Active physical exercise, good nutrition and adequate sleep were the preferred nursing measures to maintain their physical and mental health. |